Depressive Symptoms as a Longitudinal Predictor of Sexual Risk Behaviors Among African-American Adolescents

• Published in: Health psychology 2019-11, Vol.38 (11), p.1001-1009
• Main Authors: Foley, Jacklyn D, Vanable, Peter A, Brown, Larry K, Carey, Michael P, DiClemente, Ralph J, Romer, Daniel, Valois, Robert F
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent sexuality; Adolescents; African Americans; African Americans - psychology; Depression - psychology; Female; Females; HIV; Human; Human immunodeficiency virus; Humans; Infections; Intervention; Longitudinal Studies; Major Depression; Male; Medical screening; Mental depression; Partners; Prevention programs; Preventive medicine; Public health; Refusal; Risk assessment; Risk behavior; Risk factors; Risk-Taking; Safe Sex; Safe sexual practices; Self-Efficacy; Sexual behavior; Sexual Behavior - psychology; Sexual health; Sexual Risk Taking; Sexually Transmitted Diseases; Statistical Analysis; STD; Symptoms; Teenagers
• ISSN: 0278-6133; 1930-7810
• DOI: 10.1037/hea0000780

Objective: Understanding individual level factors associated with sexual risk behaviors among African-American adolescents remains an important public health priority. The current secondary data analysis examined the longitudinal association between a baseline assessment of depressive symptoms and sexual risk behaviors reported 6 months later; the purpose was to determine whether the association of depressive symptoms to risky sex varies as a function of gender. A secondary aim was to examine self-efficacy for sex refusal and condom use assessed at a 3-month follow-up as mediators of the depressive symptoms-sexual risk relationship. Methods: The sample consisted of 782 sexually active African-American adolescents (Mage = 15.3 years, SD = 1.08; 54% female) recruited to participate in a sexual health intervention trial. Data analyses focused on vaginal sex, and outcomes included: (a) sexual activity with 2 or more partners in the previous 3 months; (b) the relative frequency of condom use in the previous 3 months; (c) noncondom use at last occasion of sex; and (d) positive sexually transmitted infection (STI) screening. Results: Depressive symptoms predicted sex with 2 more partners for female participants, but no other risk markers for the sample as a whole. However, there was a significant indirect effect of depressive symptoms on condomless sex via decreased condom use self-efficacy for both male and female adolescents. Conclusions: These findings have important implications for HIV/STI prevention, in which behavioral interventions may benefit from modules that include a focus on the influence of mood on self-efficacy for safer sex practices.